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813 -780 -0020 � }} City of.Zephyrhills Fire Fax - 813 -780 -0021 <br /> / - Permit Application <br /> Date Received NW a... r,. =.max _.. • : -� .. for Permit <br /> Phone Contact fo <br /> Owner's Name ' l Z ' —,' .. ' ■ ^- ' Owner's Phone Number <br /> Owner's Address <br /> Fee Simple Titleholder Name Titleholder Phone Number <br /> Fee SimpleTitleholderAddress I <br /> NIZIONMUNSIMMINIMENBC <br /> Job Address r w / 9 --_-- <br /> -_ -- Lot # <br /> Sub Division Parcel # <br /> SMISSEMERIMMEXEZEINNEEMINIMUNNWP <br /> .r,. <br /> I-1 Bio-Hazard Waste Storage - ANNUAL n Fumigation - Tent <br /> I-1 Comm Exhaust Kitchen Hood/Duct n Hazardous Material (Tier II or RQ Facility) ANNUAL <br /> Controlled Bum = Hood Installation <br /> n Emergency Generator < 30 kw n LP /Natural Gas - Installation <br /> n Emergency Generator> 30 kw n LP /Natural Gas - ANNUAL Sal <br /> Fire Protection Maintenance - ANNUAL n Places of Assembly -ANNU ��; ! 7 <br /> ry (Semis j Other /� U'C_. <br /> • <br /> i <br /> Sprinkler n ❑ ❑ ❑ Recreational Bum • <br /> Fire Alarm El ❑ ❑ ❑ I I 1 1 Sparklers <br /> Hood Cleaning n ❑ ❑ ❑ I I ( I Sprinkler System Installations �` <br /> Hood Suppression = ❑ ❑ ❑ 1 I n Standpipes (Sprinkler Sys) <br /> n Fire Alarm Installation �Ai/ Li = Torch Roofin t ar Kettle <br /> I <br /> Fire Pumps �J (/ Wa - ge AN <br /> Fire Works L (f-• <br /> n Flammable Application- ANN A 0ltl,' �� Valuation of Project <br /> El Fuel Tanks <br /> n Other: I 1 A P <br /> i. rrr <br /> Contractor •• mp• • <br /> Signature ) Registered Y / N I Fee Current I Y / N <br /> Address I License # I <br /> ELECTRICIAN Company <br /> Signature I Registered Y / N J Fee Current 1 Y / N I <br /> Address I ( License # I I <br /> PLUMBER Company <br /> Signature Registered Y/ N j Fee Current I Y/ N j <br /> Address I I . License # I <br /> MECHANICAL Company <br /> Signature Registered Y/ N I Fee Current I Y/ N J <br /> Address I I License # I <br /> OTHER Company <br /> Signature Registered Y N 1 Fee Current I Y/ N j <br /> Address License # <br /> Directions: <br /> Fill out application completely. <br /> Owner & Contractor sign back of application, notarized (Or, copy of signed contract with owner) . <br /> If over $2500, a Notice of Commencement is required (Mechanical work over $5000) <br /> Supply two (2) sets of drawings with applicable documentation <br /> Allow 10-14 days for review after submittal date. Parcel # - obtained from Property Tax Notice (http: / /appraiser.pascogov.com) <br />